Residual joint pain after chemotherapy

[Charley E]

My wife, age 50, was diagnosed with breast cancer in May of 2002, and had a lumpectomy.  She has undergone chemotherapy and radiation treatment starting in July of 2002 and continuing through Dec 2002.  She received treatment with docetaxel, cyclophosphamide, and doxorubicin.  She received six cycles every three weeks of the chemo and 35 radiation treatments.  During chemotherapy she received treatment with neulasta and aranes.  She is now taking arrimidex, protonix, and effexor. After completing all of the treatments, she began to complain of severe joint pain in her fingers.  In the morning, they are almost unmoveable.  During the day the pain subsides and she is able to once again move them.  The radiation oncologist said that this is not unusual however did not offer any suggestions as to how to alleviate the problem.  Is this unusual and is there anything that she can take to help this?  She has tried glucosamine and that doesn't seem to have helped.

[aries]

Tell your wife to give it time. I too had joint pain along with swelling of my fingers due to chemo. I had 6 treatments (start: Apr.11,-end: Aug. 1 2002) of adriamycin, cytoxin and flourouracil. I was informed by both my oncologist and neurologist that these drugs do not cause peripheral neuropathy, but I beg to differ. Approx. half-way through treatment, I experienced pain and stiffness in my finger joints along with swelling. This would occur while sleeping and when aroused would be quite painful upon opening or clenching my hand. I also experienced tingling and numbness in my right hand and arm, which was later diagnosed as borderline carpel tunnel syndrome. The pain and stiffness would subside approximatly 1/2 hour upon awakening. It was only as recent as 1 to 2 months ago that the swelling completely subsided. The joint pain and slight numbness has lingered slightly in my right hand but has completely vanished in my left. Since I had no problems at all before chemo, I can't help but think it caused these symptoms.

[CCF-RN,MSN-JS]

Dear Charley E., Is there any numbness or tingling that accompanies this pain?  That might be a peripheral neuropathy that can be a long term effect of the chemotherapy, if so, the further from chemotherapy the better it may get, however, there are instances where there is long-term effects that do not go away and need to be managed symptomatically.  Treatment of peripheral neuropathy ranges from simple comfort measures such as warm compresses, to use of B-complex vitamins, to prescription medications.  Effexor is used to help in the treatment of neuropathic pain.  

This might also be an arthritis problem?  If so anti-inflammatory medications may be more helpful (aspirin, ibuprophen).  Of course, check with her doctor regarding these especially since she is on the protonix.

[Deb415]

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